EUROPEAN
COMMISSION
Brussels, 3.4.2017
COM(2017) 149 final
REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT AND
THE COUNCIL
Implementation of the third Programme of Community action in the field of health in
2014
{SWD(2017) 119 final}
EN
EN
Table of contents
Introduction ................................................................................................................................ 3
Action of the year — thematic focus of 2014: chronic diseases ................................................ 5
1.1 PATHWAYS Project — Participation to healthy workplaces and inclusive strategies
in the work sector ................................................................................................................... 5
Initiatives that directly contribute to implementing EU law ...................................................... 6
1.2 Request for service — implementation of the Cross-border Healthcare
Directive 2011/24/EU ............................................................................................................. 6
Budget implementation .............................................................................................................. 7
1.3
Budget .......................................................................................................................... 7
1.4
Priorities for 2014 and financing mechanisms ............................................................ 8
1.5
Implementation of the operational budget by financing mechanism .......................... 8
1.6
Direct grant agreements with international organisations ......................................... 13
1.7
Procurements (service contracts) ............................................................................... 13
1.8
Other actions .............................................................................................................. 14
1.9
Budget consumption in 2014 ..................................................................................... 15
1.10 Type of beneficiaries ................................................................................................. 15
Conclusion ................................................................................................................................ 16
2
INTRODUCTION
This report presents the implementation of the Third Health Programme in 2014. This was the first
year of the implementation of the Third Health Programme established by Regulation (EU)
No 282/2014 of the European Parliament and of the Council of 11 March 2014.1 This Regulation
applies from 1 January 2014 for a Programme lasting seven years until 31 December 2020. Under
Article 13 of the Regulation, the Commission must report to the Health Programme Committee on the
implementation of all actions funded through the Programme, and keep the European Parliament and
the Council informed. This report meets that requirement. It provides detailed information on the 2014
budget and how it was spent.
The accompanying Staff Working Document in Annex 1 presents a set of examples of the key multiannual actions co-funded under the Second Health Programme2 for which final results became
available in 2014. It also describes examples of action funded under the 2014 work programme in
ancillary fields such as evaluation and dissemination. Overview tables detailing all activities cofunded and contracts provided can be found in Annexes 2-10.
The Third Health Programme has a total budget of EUR 449 400 000. It has four specific objectives:
1. to promote health, prevent diseases and foster supportive environments for healthy
lifestyles taking into account the ‘health in all policies’ principle;
2. to protect Union citizens from serious cross-border health threats;
3. to contribute to innovative, efficient and sustainable health systems;
4. to facilitate access to better and safer healthcare for Union citizens.
The Programme defines progress indicators for each objective. To reach these objectives, the
Programme can be implemented using a wide range of funding instruments. These are:




action co-financed with Member State authorities (‘joint actions’);
projects and operating grants to specifically support non-governmental organisations and
networks;
direct agreements with international organisations, public procurement; and
other actions.
In line with the multi-annual plan drawn up in 2013, the 2014 annual work programme focused on
chronic diseases. Hence, several actions to tackle chronic diseases were co-funded in 2014; one is
highlighted in this report. The Programme also co-funds initiatives that help implement EU law. This
report provides two examples of how the Programme was successful in this area in 2014.
Looking ahead…
In this first year of the Third Health Programme a number of important initiatives, including eight
joint actions, were supported and started thanks to Programme co-funding. In line with the conclusions
from the ex post evaluation of the Second Health Programme, the Commission ensures that the
implementation of the Third Health Programme is closely monitored and that results are publicised
more widely. The Commission further continues to encourage and foster the participation of all
1
OJ L 86, 21.3.2014, p. 1.
2
OJ L 301, 20.11.2007, p. 3.
3
Member States and countries participating in the Programme and seek synergies with other EU
funding programmes.
4
ACTION OF THE YEAR — THEMATIC FOCUS OF 2014: CHRONIC DISEASES
The priority health topic for the 2014 annual work programme was chronic diseases. Overall,
three calls for proposals for projects on different aspects of chronic disease prevention and
management were launched, resulting in five co-funded projects. A joint action on nutrition
and physical activity and another one on dementia were concluded, as were six projects in the
area of active and healthy ageing. The PATHWAYS project described below is a good
example. It addresses the important issue of the participation of chronic disease patients in the
work force. This is fully in line with the Commission’s agenda on jobs and growth.
1.1
PATHWAYS Project — Participation to healthy workplaces and inclusive
strategies in the work sector
1.1.1 Background
PATHWAYS — Participation to healthy workplaces and inclusive strategies in the work
sector was one of the projects co-funded in 2014 as part of the focus that year on chronic
diseases. PATHWAYS started in summer 2015, will run for 36 months and will receive up to
EUR 969 379.00 in co-funding. It involves 12 partners from 10 different European countries
(Austria, Belgium, the Czech Republic, Germany, Greece, Italy, Norway, Poland, Slovenia
and Spain), all of whom have vast expertise in the area of chronic and mental conditions and
employment.
1.1.2 Brief description
People with chronic diseases and mental disorders often experience work-related problems,
such as unemployment, absenteeism, reduced productivity and stigmatisation in the
workplace. The rising prevalence of chronic diseases and mental disorders against budget
austerity requires innovative strategies to help these people participate in the labour market.
However, we lack knowledge about available strategies and whether they are effective. We
must also clarify the employment-related needs of people with chronic diseases and mental
disorders. Hence, in response, PATHWAYS will identify integration and reintegration
strategies that are available in Europe and beyond and determine their effectiveness. It will
further assess the specific employment-related needs of people with chronic diseases and
mental disorders. Lastly, it will develop guidelines to support the implementation of effective
professional integration and reintegration strategies. Stakeholder consultations will be one
method used.
1.1.3 Expected results
PATHWAYS will provide a series of reports, including:


one comparing the available strategies based on the five categories of social welfare
and healthcare models in Europe; and
one on unmet employment needs in people with chronic diseases, including
recommendations on how to tackle them.
5
A database will compile the available evidence on the effectiveness of existing integration
and reintegration into work strategies for people with chronic conditions, and the evidence
will be described in a scoping paper.
Lastly, PATHWAYS will conclude with policy recommendations to implement inclusive
strategies towards a more inclusive labour market in which people with chronic diseases and
mental disorders can participate meaningfully.
INITIATIVES THAT DIRECTLY CONTRIBUTE TO IMPLEMENTING EU LAW
The Health Programme funds services provided by external contractors that support the
Commission in implementing decisions and directives in the field of health. Below one
example of such services that were carried out in 2014.
1.2
Request for service — implementation of the Cross-border Healthcare
Directive 2011/24/EU
1.2.1 Background description
This study considered the effects of the Cross-border Healthcare Directive 2011/24/EU3. Its
overall objective was to report on Member States' implementation of the Directive, as
required under Article 20(1), and identify gaps and potential for improvement. The study
drew on the situation on the ground and other valuable external sources. These services were
provided through a service contract with KPMG Advisory N.V., Technopolis Group and
Empirica GmbH, under the framework contract SANCO/2012/02/011 — Lot 1. The contract
ran from 21 July 2014 to 21 March 2015 at a cost of EUR 179 026.
1.2.2 Brief description
In addition to desk research and a literature review, a detailed website review and widely used
participatory research methods were used. Building on previous research efforts, all the
websites of the 32 national contact points for cross-border healthcare (NCPs) were analysed
(32 countries or territories as Scotland, Wales, England, Northern Ireland and Gibraltar were
included separately for the UK).
The ‘pseudo-patient’ research method was used to take account of the ‘end-user’ perspective.
The evaluators approached NCPs in 12 Member States (Austria, Belgium, France, Germany,
Hungary, Italy, Lithuania, Malta, the Netherlands, Slovenia, Spain and Sweden) by both email
and telephone using three different pre-designed scenarios.
Subjective, opinion-based data were also collected in the focus countries and at European
level via 59 stakeholder interviews and an online survey addressed to the NCPs in the focus
3
OJ L 88, 4.4.2011, p.45
6
countries. Some 50 % of stakeholders contacted agreed to be interviewed over the four-week
period. They represented a range of health insurance providers, healthcare providers, patient
ombudsmen, national and regional authorities, patient groups, audit bodies, trade unions and
frontline healthcare prescriber organisations. All NCPs completed at least a part of the online
survey. A Strength-Weakness-Opportunities-Threats (SWOT) analysis focusing on the
services provided to the patients complements the conclusions of the study.
1.3.3 Specific results
This study is part of ongoing work to build a zero baseline as a starting point for measuring
and assessing cross-border healthcare in the Union. As a general finding, all the stakeholders
involved confirmed that the number of patients having made use of cross-border healthcare
under the Directive is low.
This study delivers a meaningful, albeit qualitative contribution to the baseline assessment
and to future evaluation efforts, in line with the ‘evaluate first’ principle. The study findings
were published in May 2015 on the European Commission’s website and were presented at
the NCPs’ meeting organised by the European Commission on 2 December 2015, where they
were met with great interest. It is hoped that the methodological avenues of the study will be
explored further by interested stakeholders and by the wider research community.
This study is, however, not a formal evaluation. Complaints, infringements and transposition
measures were not part of its remit. Given the recent adoption of the Directive and the scarcity
of readily available data on patient mobility, a formal evaluation of the Directive would have
been premature.
BUDGET IMPLEMENTATION
1.3
Budget
The budget for the Third Health Programme 2014-2020 is EUR 449.4 million. This includes
EUR 33.48 million for the functioning of the Consumer, Health, Food and Agriculture
Executive Agency (Chafea) which the Commission has asked to manage the Health
Programme 2014-2020. Chafea has been providing the Commission with technical, scientific
and administrative assistance in implementing the Health Programme since 2005.4 It organises
annual calls for proposals, coordinates the evaluation of submissions, and negotiates, signs
and manages related grant agreements. It is also responsible for many procurement
procedures.
The budget set out in the work plan for 20145 was EUR 58 579 000, broken down as follows:
4
Decision 2004/858/EC of 15 December 2004 (OJ L 369, 16.12.2004, p. 73) amended by Decision 2008/544/EC
of 20 June 2008 (OJ L 173, 3.7.2008, p. 27).
5
Commission Decision C(2014) 3383 of 26.5.2014,
http://ec.europa.eu/health/programme/events/adoption_workplan_2014_en.htm.
7


operational expenditure: EUR 52 870 000, corresponding to budget line 17 03 01
Encouraging innovation in healthcare and increasing the sustainability of health
systems, improving the health of the Union citizens and protecting them from crossborder health threats;
administrative expenditure: EUR 1 500 000 — corresponding to budget line
17 01 04 02 — support expenditure for Health for Growth programme.6
The total operational budget – including in addition EFTA/EEA credits and recovery credits
from previous budget years - was EUR 54 856 308.05 and the total administrative budget was
EUR 1 547 747.69.
In 2014, Chafea managed EUR 44 541 244.83 of this budget, while the Commission managed
EUR 9 409 832.88 covering procurement, direct grants and other measures.
1.4
Priorities for 2014 and financing mechanisms
The priorities for 2014 were set out in Commission Implementing Decision C (2014) 3383 of
26 May 2014 concerning the adoption of the 2014 work programme and related criteria.7
Several financing mechanisms were used to implement the work plan for 2014. These are
described in detail below.
Competitive selection and award procedures were used to select initiatives for funding.
Competitive selection and award procedures are not used for joint actions, direct grant
agreements and conferences organised by Council presidencies because in those cases
competitive procedures are either not allowed under the specific rules or are not used in
practice, for example due to a monopoly situation.
Administrative credits covered expenditure such as studies, meetings of experts, information
and publication costs, and technical and administrative assistance for IT systems.
1.5
Implementation of the operational budget by financing mechanism
Type of financing mechanism
Calls for proposals
Project grants
Implementation
(EUR)
Share of mechanism
in total executed
budget
17 393 292.88
12 677 193.08
31.7 %
23.1 %
The name originally proposed for the Third Health Programme was ‘Health for Growth’ Programme: hence,
the name of the budget line. As this name was not retained, the budget line has been re-named for the work
programme 2016.
6
7
http://ec.europa.eu/health/programme/events/adoption_workplan_2014_en.htm.
8
Operating grants
Grants for joint actions
4 716 099.80
18 506 972.39
8.5 %
33.7 %
157 901.00
0.2 %
7%
Managed by CHAFEA
3 849 825.96
2 700 000.00
Managed by DG SANTE
1 149 825.96
Conference grants to the Member States
holding the presidency of the EU
Direct grant agreements
Procurement (service contracts)
Managed by CHAFEA
Managed by DG SANTE
Other actions
12 769 292.44
23.3 %
5 283 078.56
7 486 213.88
9.7 %
13.6 %
1 273 793.04
2.3 %
Managed by CHAFEA
500 000.00
Managed by DG SANTE
773 793.04
Budget spent in 2014
53 951 077.71
Total available budget
Credits not used8
54 856 307.05
by CHAFEA
711 310.68
by DG SANTE
193 918.66
Budget spent
98.3 %
By way of comparison, the table below shows the percentage of the available budget spent per
financial mechanism on average in the Second Health Programme and in 2014. While a lower
proportion was spent on projects in 2014, more was spent on joint actions. The percentages
are similar for other financial tools.
Type of financing mechanism
Project grants
Share of mechanism Share of mechanism
in
total
executed in
total
executed
budget in 2014
budget in Second
Health Programme
23.1 %
36 %
8
Pre-accession credits not yet used, differences between amounts in the award decision and amounts actually
contracted.
9
Operating grants
Grants for joint actions
8.5 %
33.7 %
7%
22 %
Direct grant agreements
Procurement (service contracts)
4.9 %
23.0 %
7%
25 %
2.3 %
4%
Other actions
Calls for proposals
Calls for proposals — for projects and operating grants actions —were launched on
6 June 2014 on the Participant Portal of the Horizon 2020 Programme,9 the public health
website on EUROPA10 and on Chafea’s website.11 Most applications were received from main
partners in EU-15 Member States, who accounted for 86 % of project applications, 100 % of
operating grant applications, and 100 % of joint action applications. 41 % of all partners in the
joint actions are from EU-13 countries, as are 16 % of the project partners.
Chafea organised a joint action workshop in October 2014 and a joint action quality assurance
workshop in February 2015. The National Focal Points for the Health Programme also
organised national information days in BG, HR, CZ, EL, HU, IE, IT, LT, NL, NO, PL, PT,
RO, SK, ES and UK. Guidelines for applicants were made available on the Participant Portal.
The Chafea helpdesk also provided assistance and practical help.
Altogether, 50 proposals for projects and 40 operating grant proposals were received for an
amount totalling EUR 42 887 771. Applications were evaluated in accordance with the rules
and criteria set out in Commission Implementing Decision C (2014) 3383 and the calls for
proposals. 37 external experts from 18 countries took part in the evaluation process. The
experts were drawn from a list established following a call for expressions of interest entitled
‘call for expressions of interest in the area of public health’.12
The evaluation process took place in two stages.
In the first stage, three external evaluators reviewed each proposal. A consolidated evaluation
report for each proposal was drawn up at a meeting organised by Chafea.
9
http://ec.europa.eu/research/participants/portal/desktop/en/opportunities/3hp/index.html#c,calls=hasForthcoming
Topics/t/true/0/1/0&hasOpenTopics/t/true/0/1/0&allClosedTopics/t/true/1/1/0&+PublicationDate/desc
10
http://ec.europa.eu/health/programme/policy/index_en.html.
11
http://ec.europa.eu/chafea/health/index.html.
12
OJ S 040-065407, 26.2. 2014 and http://ec.europa.eu/chafea/ami/.
10
In the second stage, the evaluation committee checked that the evaluators had complied with
the relevant rules and criteria. It then drew up final lists of proposals recommended for
funding, together with reserve lists. The evaluation committee comprised representatives from
the Directorate-General for Health and Food Safety (DG SANTE), the Directorate-General
for Research and Innovation and from Chafea. The award decision for projects13 and
operating grants14 were taken by Chafea.
1.5.1 Project grants
Project grants were awarded to actions involving several partners, usually public health bodies
and non-governmental organisations. The maximum EU contribution is 60 % of eligible costs.
However, the EU contribution may go up to 80 % if a proposal meets the criteria for
exceptional utility. In 2014, two projects qualified for exceptional utility.
In all, 50 proposals were submitted in response to the call for proposals for projects. Six
proposals were excluded in the screening phase. Out of the remaining 44 proposals 12 were
recommended for funding and four were placed on a reserve list. In the end, 13 projects were
funded for a total of EUR 11 567 617. Their distribution among the programme objectives
was as follows:
1. health promotion: EUR 3 535 947 (5 projects);
2. health threats: no projects funded;
3. health systems: EUR 8 031 670 (7 projects);
4. better and safer healthcare: no projects funded.
The annex lists all projects funded.
1.5.2 Operating grants
Operating grants were awarded to non-profit organisations or networks that are:







13
non-governmental;
non-profit-making and independent of industry, commercial and business or other
conflicting interests;
working in the public health area;
play an effective role in civil dialogue processes at Union level;
pursue at least one of the specific objectives of the Programme;
active at Union level and in at least half of the Member States; and
have a balanced geographical coverage of the Union.
http://ec.europa.eu/chafea/documents/health/list-projects-2014_en.pdf.
14
http://ec.europa.eu/chafea/documents/health/award-fpa-agreements-2014_en.pdf and
http://ec.europa.eu/chafea/documents/health/specific-grant-agreements-2014_en.pdf.
11
The maximum EU contribution is 60 % of their annual operating costs. However, the EU
contribution may increase to 80 % if a proposal meets the criteria for exceptional utility. In
2014, only four operating grants qualified for exceptional utility.
With the start of the Third Health Programme, Chafea introduced the call for multi-annual
‘framework partnership’ instrument. The holders of three-year framework partnership
agreements can then apply for annual co-funding. A total of 40 proposals were submitted in
response to the call for proposals for operating grants. Of these, 14 were awarded a
framework partnership agreement (35 % of the proposals received). All of them received an
annual operating grant for 2015. The total co-funded was EUR 4 716 099.80
The annex lists all operating grants funded.
1.5.3 Joint actions
Grants for joint actions were awarded to competent authorities or public sector bodies and
non-governmental bodies mandated by those competent authorities. The maximum EU
contribution is 60 %. However, the EU contribution may go up to 80 % if a proposal meets
the criteria for exceptional utility. In 2014, only two joint actions qualified for exceptional
utility.
The procedure for joint actions under the Third Health Programme has changed. In order to
assure more transparency and inclusiveness, the Member States and countries participating in
the Third Health Programme now nominate the competent authorities or other bodies as a first
step. Then, those nominated are invited to submit a proposal under the direct grant procedure.
Eight joint actions were co-funded for a total of EUR 18 506 972.39. They were distributed
among the programme objectives as follows:
1. health promotion: EUR 5 698 457.39 (three joint actions);
2. health threats: EUR 3 499 873.00 (one joint action);
3. health systems: EUR 2 599 999.00 (two joint actions);
4. better and safer healthcare: EUR 6 708 643.00 (two joint actions).
These joint actions each involved between 10 and 24 Member States and other countries
taking part in the programme; involving on average 19 per joint action.
The health topics covered by the joint actions are:





unbalanced dietary habits and physical inactivity;
improvement of HIV and co-infection prevention and treatment in priority regions and
priority groups in the European Union;
coordinated action to improve the situation and career of people with dementia;
highly dangerous and emerging pathogens;
technical and scientific cooperation on medical devices and in vitro diagnostic medical
devices;
12



support for the eHealth Network;
implementation of the Council Recommendation and Commission Communication on
Rare Diseases15; and
monitoring and control in the field of blood transfusion and tissue and cell
transplantation.
The annex lists all the joint actions funded.
1.6
Direct grant agreements with international organisations
Direct grant agreements with international organisations were awarded to international
organisations active in the area of public health. The direct grants also include service-level
agreements. The maximum EU contribution is 60 %.
All in all, seven direct grant agreements were signed, for a total of EUR 3 849 825.96 as
follows:
Four were signed by Chafea, namely:
1) the contribution agreement with the Council of Europe for the integration of EU
legislation on substances of human origin (EUR 500 000);
2) the annual direct grant agreement with the European Pharmacopoeia
(EUR 1 100 000);
3) two direct grant agreements with the World Health Organisation:
 monitoring of the national policies related to nutrition, physical inactivity,
overweight and obesity (EUR 600 000); and
 monitoring of the national policies related to alcohol consumption and harm
reduction (EUR 500 000).
Three were signed by DG SANTE, namely:
1) two direct grants (cross sub-delegation/service-level agreement) to Eurostat regarding
morbidity statistics for a total of EUR 1 099 825.96; and
2) one direct grant to the Pharmaceutical Inspection Cooperation Scheme for training in
the area of active pharmaceutical ingredients for EUR 50 000.
The annex lists all direct grant agreements that were funded.
1.7
Procurements (service contracts)
Procurement (service contracts) was used to purchase services. The Programme fully covers
the cost of procurement.
These service contracts cover needs as specified in the work plan for 2014:

15
evaluation and monitoring of actions and policies;
http://ec.europa.eu/health/ph_threats/non_com/docs/rare_com_en.pdf
13








studies;
advice;
data and information on health;
scientific and technical assistance;
communication;
dissemination;
awareness-raising activities; and
IT applications to support policies.
In 2014, DG SANTE signed several service contracts and specific requests using existing
framework contracts. Most of these contracts and requests were for horizontal actions such as
communication and IT services for maintenance and functioning of existing IT tools (i.e. the
EMP database, EUDAMED, Health Policy Platform, etc.). Procurement contracts also
included contracts with experts working for the scientific committees and evaluation and
monitoring studies. The overall public procurement budget managed by DG SANTE
amounted to EUR 7 486 213.88.
In 2014, Chafea managed 22 new market procedures for the acquisition of services (four
contracts under health promotion, four contracts under health threats, six contracts under
health systems, five under better and safer health care) and three on horizontal communication
for a total of EUR 5 283 078.56.
The amounts per objective and authorising organisation were as follows:
Health Programme objective
Health promotion
Procurement managed by DG Procurement managed
SANTE (EUR)
Chafea (EUR)
1 353 200.72
1 280 967.00
Health threats
0
Health systems
1 327 335.79
Better and safer healthcare
733 684.35
Horizontal
4 071 993.02
TOTAL
8 260 006.92
The annex lists all service contracts signed.
1.8
by
1 802 209.40
864 927.50
1 213 163.00
121 811.66
5 283 078.56
Other actions
EUR 2 184 000 was earmarked for other actions in 2014. The ‘other actions’ include experts’
fees, for example:



the expert panel on effective ways of investing in health;
for experts carrying out system inspection on pharmaceutical ingredients;
for experts participating in the international conferences on the harmonisation of
technical requirements for the registration of pharmaceuticals for human and
veterinary uses.
14
This also includes cost of administrative agreements with the Joint Research Centre and
covers the Commission’s membership fee to the European Observatory on Health Systems
and Policies. For more information on what specific actions fell under the banner ‘other
actions’, please refer to the annex.
1.9
Budget consumption in 2014
All in all, the total operational budget for 2014 was divided among the four specific objectives
of the Third Health Programme as follows:
1.
2.
3.
4.
health promotion: EUR 16 113 811.99 (30.6 % of the operational budget in 2014);
health threats: EUR 5 302 082.40 (10.1 % of the operational budget in 2014);
health systems: EUR 16 537 850.33 (31.4 % of the operational budget in 2014);
better and safer healthcare: EUR 10 653 702.35 (20.2 % of the operational budget in
2014);
5. horizontal activities (IT, communication): EUR 4 193 804.68 (7.8 % of the operational
budget in 2014).
Chart 1 — Operational budget use in 2014 by Third Health Programme objective
1.10 Type of beneficiaries
In 2014, nearly 40016 different grants and contracts were signed with diverse beneficiaries and
service providers ranging from governmental and non-governmental organisations to
academic institutions and private companies. The category ‘other’ includes beneficiaries such
as health care providers and international organisations. Chart 2 provides an overview of the
different groups of beneficiaries.
16
This excludes contracts made with single experts e.g. those participating in the Scientific Committees.
15
Chart 2 — types of beneficiaries of the Third Health Programme in 2014
CONCLUSION
2014 was the first year of the Third Health Programme, which was adopted by European
Parliament and Council on 11 March 2014. Consequently, the annual work programme was
adopted two months later on 26 May 2014 and thus the whole implementation cycle was also
delayed. Thus, most of the grant agreements and several service contracts were signed in the
first trimester of 2015. The Third Health Programme Regulation makes some significant
improvements compared to the Second Health Programme. These include:



specific objectives with related indicators;
a clear definition of ‘EU added value’; and
introducing criteria to define ‘exceptional utility’ for joint actions.
This meant, for example, that applicants and evaluators were better guided by the definition
of ‘EU added value’ and it was easier for joint action consortia to develop the proposal in
such a way that it would qualify for exceptional utility, i.e. 80 % co-funding.
There were also several positive changes as regards the implementation of the Third Health
Programme. These included the introduction of online submissions via the Participant Portal;
and online evaluation and electronic signature of the grant agreements. The Regulation also
introduced simplified administrative procedures and direct grant agreements for joint actions
and framework partnership agreements for operating grant holders to enable the recipients of
these grants to carry out longer-term planning.
The new procedure for joint actions is also more transparent because as a first step the
consortium needs to be established through nominations by Member States/countries
participating in the Third Health Programme. However, this means that EU umbrella non-
16
governmental organisations in particular face the challenge of being nominated, whereas
during the Second Health Programme they were nominated by the Commission.
The number of participants in joint actions continues to be relatively high, as already seen in
the Second Health Programme: on average 25 participants per joint action in 2014 — ranging
from 12 to 39. This is a challenge for the overall management and coordination of the joint
actions. When looking at the calls for proposal for projects, it can be observed that for two
calls no project has been awarded. In one case this was because no applications were received,
possibly because the theme was defined rather narrowly and the co-funding proposed
relatively low. In the second case several proposal were received, but all were excluded in the
evaluation due to insufficient quality.
Following the recommendations of the ex post evaluation, further improvements are due to be
implemented in the coming years, including an enhanced electronic monitoring and reporting
system, better and more targeted dissemination and continued efforts to increase the
participation of organisations and institutions from those countries which, until now, have
been under-represented among the beneficiaries.
17